Another common condition that previously required laparotomy for treatment are uterine fibroids, which affect roughly 1 in 4 women. The first documented surgical management of this condition involves a large incision used to treat Abraham Lincoln’s cousin back in the 1800s, and, in fact, throughout the early 1900s, a successful surgeon was defined as one with only “minimal” fatalities. Since then, we’ve certainly advanced our treatment options as even uterine fibroids too large to manage with vaginal surgery can often be treated with a robot-assisted approach and no longer require large incisions with prolonged hospital stays.
In addition to providing a quicker recovery than open surgery, robotic surgery also allows for treatment of more complicated conditions than either vaginal or traditional laparoscopic approach. In fact, with an experienced robotic surgeon, a study in the International Journal of Obstetrics and Gynecology suggests that there are fewer complications during surgery and the postoperative period with robot-assisted procedures in comparison to other approaches, despite performing more complex surgical procedures.
Why does robot-assisted surgery work so well? Likely, it is due to improved visualization with 3D optics, more dextrous movements, standard safety features (unlike other surgeries, the instruments cannot be moved unless the surgeon is looking into the viewing console), and translation of the surgeon’s hand movement into smaller, more precise movements of tiny instruments within the patient’s body.
To accomplish even greater range of motion than the human hand, one might expect the need for large incisions; however, this is certainly not the case. Some cases can be done through a single incision in the belly button measuring just one inch, and the rest can be completed through 3-4 small incisions measuring between 8-12mm (less than half an inch). In addition to fantastic cosmetic results, the smaller incisions allow a woman to recover faster so she can get back to doing what she loves.
Along with the management of prolapse, robotic surgery can be used to treat heavy menstrual bleeding, pelvic pain, and endometriosis. If a woman has finished having children, then a hysterectomy may be the correct approach, although if a woman is planning to become pregnant in the future, a more conservative treatment with fertility-sparing removal of fibroids or endometriosis may be a better option. Other robot-assisted GYN surgeries include tubal ligation reversal for those who desire more children and placement of abdominal cerclage in patients whose previous vaginal cerclage wasn’t successful.
With all of these treatment options, this new approach can provide a great surgical experience for many women, and, even though robot-assisted surgery is the latest in surgical technology, it is hardly unproven. In fact, over 3 million robot-assisted procedures have been performed since the technology was introduced in 2000. If you are a woman in need of gynecologic surgery, be sure to check with your physician and find out if you are a candidate for a robot-assisted procedure.